Mental health providers play a critical role in military operations, supporting service members who have been exposed to stressful or traumatic events, providing skills to build unit resilience and reduce stress – ultimately preserving mission and readiness.

That’s why Uniformed Services University’s (USU) Clinical Psychology degree program within School of Medicine, and the Psychiatric Mental Health Nurse Practitioner (PMHNP) program within USU’s Graduate School of Nursing, have been collaborating to ensure their students are prepared to provide that critical support.

As part of each program’s curriculum, students have an opportunity to participate in USU’s annual medical field practicum, Operation Bushmaster. The exercise is held at Fort Indiantown Gap, an Army National Guard training center north of Harrisburg, PA, and is designed to enhance the student operational experience – immersing them in a simulated combat environment, complete with mock explosions, moulaged “casualties,” reality-based missions, and simulated helicopter evacuations. Bushmaster is the final exam in the USU Department of Military and Emergency Medicine’s Military Contingency Medicine course, and it’s designed to challenge and test students’ knowledge of military medical practice, as well as their leadership skills.

Clinical Psychology students gain realistic practice during Bushmaster. They also increase their value as mental health providers. (photo courtesy of U.S. Public Health Service Capt. (Dr.) Jeffrey Goodie)

Participating in Bushmaster gives Clinical Psychology and PMHNP students a chance to gain realistic practice in a simulated deployment environment, enhancing their skillset, explained U.S. Public Health Service Capt. (Dr.) Jeffrey Goodie, director of Clinical Training in USU’s Department of Medical and Clinical Psychology.

“Bushmaster plays a huge part in allowing them to understand the special requirements needed to serve in this role, allowing them to think of themselves as a clinical provider in a deployed setting,” Goodie said. “This opportunity also sets our program apart from others, and increases their value as mental health providers.”

He added that students often learn material best by putting it into context, and so being at Bushmaster, immersed in a very realistic, simulated deployment setting, practicing their skills, they are truly having a chance to put what they’ve learned into context.

Students in their third year of the five-year clinical psychology degree military track, along with the PMHNP students in the second year of their three-year program, will spend eight days participating in Bushmaster. They will set up and run a Combat and Operational Stress Control (COSC) clinic, much like they would if they were in an actual deployed setting, explained Army Lt. Col. JoEllen Schimmels, PMHNP program director. Their focus will be on being proactive, promoting early detection of fatigue and stress, and preparing service members to adapt to stress, while educating service members on the important role of behavioral health, she said.

These students will also set up “touch points” for each platoon to help check the pulse throughout the “deployment,” Schimmels explained, providing psychological support at the unit and individual levels as needed. Throughout their time at Bushmaster, they will also help identify potential combat stress and gain the experience of consulting with leadership to address any concerns – even if that means the combat stress is being felt by leadership and addressing it with them, Schimmels said. Their presence alone helps break down any stigma or barriers for those who may need psychological help, she added.

During the exercise, the students will have a chance to participate in a mass casualty exercise where they will practice triaging mental health “patients” – which could come as a challenge, prioritizing individuals when their wounds may not be as visible as physical wounds, she explained.

After Bushmaster, the students will receive feedback from USU faculty, increasing the value of their experience even more, added Air Force Maj. (Dr.) Ryan Landoll, assistant professor of Family Medicine, and assistant dean for Preclinical Sciences in the School of Medicine’s Office of Student Affairs. This year, those evaluating the students’ performance will also include a group of military psychology residents stationed at Joint Base Andrews, as well as a number of outside Army faculty who recently returned from a deployment, Landoll added. This makes the learning environment interdisciplinary, interservice, and across different levels of professional development, resulting in a truly unique experience for students.

Several students who participated last year said the experience was unlike any other field training exercise. For some, who had no prior military experience before coming to USU, it was a chance to use their skills in a realistic combat environment.

“As future leaders and providers in mental health, Bushmaster gave us a glimpse into our deployed role that would be impossible in any other educational setting,” said Air Force Capt. Michelle Binder, a PMHNP student who participated in the exercise last year. “Not only did it help prepare us for future clinical care, but it also gave us an opportunity to educate other students on the importance of supporting our troops’ mental health and morale needs downrange.”

Binder added that they were able to immerse themselves in the environment by visiting each platoon to conduct a Unit Needs Assessment, engaging with each platoon’s security team, obtaining buy-in from leadership, and building rapport with their unit members to learn how they could best help them. In their “real world” Bushmaster role, she said, they also engaged countless participants (including faculty, moulage artists, and leadership) to build morale and assistance from their clinic’s mascot, “Panda Pauli.”

Army Capt. Sybil Mallonee, now in her fourth year of the clinical psychology program, said she went to Bushmaster not really knowing what to expect, but what she took away was invaluable.

“I learned more about how to apply my clinical, multidisciplinary, and leadership skills in a deployed setting,” Mallonee said. “It was great to be a part of this unique exercise.”

Army 1st Lt. Hannah Martinez, a fourth-year student in the clinical psychology program, said she worked as part of a team that collected and analyzed data about the health, welfare, and morale of service members for all of the platoons in the medical operations during Bushmaster last year, and they were able to then present this information to the Bushmaster planning staff. They also were able to provide other students a break from the fast-paced tempo of the field exercise, giving them a chance to reflect on their experience and discuss what was going well and what could be going better, she said.

“It was a great experience,” Martinez said. She also appreciated the chance for inter-professional growth. “The ability for USU to graduate officers that have a level of understanding of the roles, communication skills, and abilities of other medical professionals they will be serving makes for a strong force multiplier.”

PMHNP students pose for a photo last year in the Combat and Operational Stress Control clinic during Bushmaster. They referred to the clinic as PandaKARE, named after the notional country Pandakar used during the field exercise. Their mascot - a panda named “Panda Pauli.” (photo courtesy of Air Force Capt. Michelle Binder)

Martinez also noted that psychologists have a role in all stages in deployments – they help ensure service members are safe and have coping skills before they deploy, and while down range, they help service members handle all levels of their stress while making sure they are capable of completing their mission to the best of their abilities. Then, upon re-deployment, psychologists debrief stressful missions and help service members prepare and transition back home. Simply put, clinical psychologists are trained to help leaders have the most effective team possible, she said.

“This is something I am excited about … I really look forward to being embedded with a unit and getting to know them and serve them well,” she said.

Lt. j.g. Julia Garza, also a fourth-year in the clinical psychology program, agreed the experience was a great learning opportunity, and gave her a chance to run a clinic within a deployed environment, while also interviewing platoons to determine their “real world” needs during Bushmaster.

Students in their third year of USU’s five-year Clinical Psychology program participate in Bushmaster, putting what they’ve learned in context. (photo courtesy of U.S. Public Health Service Capt. (Dr.) Jeffrey Goodie)

“We are trained in our program to be able to provide good evidence-based clinical care and taught about ethical considerations we should be considering while providing care,” Garza said. “We are also taught in our program about potential ethical dilemmas that can occur and unique challenges while working within deployed settings, but it feels very different when you are actually placed in these potential scenarios in a simulated environment like Bushmaster.”

The exercise also allowed her to experience what could potentially be stressful in a deployment setting and, more importantly, a chance to figure out how to potentially handle the situation.

“I’m really grateful that I was able to go last year because it challenged me both as a future military leader and a clinician,” Garza said. “I’m even more grateful for the immense amount of experience our preceptor team had and the invaluable feedback they offered.”